- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $2,570.40 / $7,079.46
| Facility | | $181.97 | $2,570.40 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $645.65 / $707.95
| Facility | | $338.84 | $645.65 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $380.19 / $724.44
| Professional | | $309.03 | $380.19 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $380.19 / $457.09
| Professional | | $323.59 | $380.19 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $269.15 / $501.19
| Facility | | $112.20 | $269.15 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $138.04 / $794.33
| Facility | | $104.71 | $138.04 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,818.38 / $5,754.40
| Facility | | $512.86 | $2,818.38 | $5,754.40 |